- Polycystic ovarian treatment - consult your doctor in time
Treatment of polycystic ovary is aimed at addressing the underlying problems facing the diseased woman: infertility, hirsutism (excess body hair), acne and obesity. Term and the most important aspect of treatment is to reduce the stress on the cardiovascular system, caused by obesity, high blood cholesterol levels, diabetes, and hypertension. To choose the right treatment, your doctor will most likely prescribe regular checkups with measurement of blood pressure and monitoring the blood levels of glucose and lipids.
Women with polycystic ovaries, will benefit from the expert advice that will help create a healthy diet and a program of fitness training. This is particularly important for larger women. Completeness of obesity and lower insulin resistance. Losing weight can help lower insulin levels and androgen, and restore ovulation. Unfortunately, women with PCOS lose weight
How to lose weight - basic principles
much harder than other women, so it is important regular consultations with the dietician.
To reduce the symptoms and risks associated with PCOS, except for diet and sports, the doctor also prescribe a number of medications.
Medicines to regulate the menstrual cycle
If you are not trying to get pregnant, your doctor may recommend taking small doses of oral contraceptives that combine synthetic estrogen and progesterone
Progesterone - norm and pathology
. They reduce the production of androgen and allow the body to "rest" of continuous estrogen, which reduces the likelihood of endometrial cancer and restores normal menstrual bleeding.
Alternative treatment - progesterone reception for 10-14 days each month. This treatment option regulates the menstrual cycle and provides protection against endometrial cancer, but does not affect androgen levels.
In addition, possible treatment with metformin (Glucophage, Glucophage XR) - oral medications for treating diabetes 2 degrees, which increases insulin resistance. Metformin is still undergoing tests for usefulness in the treatment of AEs, but studies have shown that it improves ovulation and possibly reduces androgen levels. However, it is not known whether metformin prevents the development of endometrial cancer, like oral contraceptives or hormone replacement therapy (receiving progesterone).
Medications to reduce hirsutism (excess body hair)
Among the several preparations for the treatment of IL physician may add some medicaments intended in particular to reduce hair growth under the influence of excessive estrogen
Estrogen - the key to bone health
in the body. Spironolactone (aldactone) blocks the effects of androgens and reduces the production of new androgen. Spironolactone - a diuretic, so during his reception frequent urge to urinate. Possible side effects include heartburn, headaches and fatigue. To reduce the level of androgen also prescribed finasteride (Propecia, Proscar) and flutamide (Eulexin).
It is also possible treatment eflornithine (Vaniqa) - cream, slows the growth of facial hair in women. Apply the cream should be used twice a day. During pregnancy, it is not recommended to use eflornithine.
Medication to increase the probability of conceiving
To become pregnant, women with PCOS need medication stimulates ovulation. Clomiphene (Clomid, Serophene) - anti-estrogen drug that should be taken during the first five days of the menstrual cycle
The days of the menstrual cycle: Four phases
. If clomiphene is ineffective, metformin was added thereto to stimulate ovulation.
If desired pregnancy does not occur even after clomiphene and metformin, administered gonadotropin therapy, in particular, follicle stimulating and luteinizing hormones which are administered by injection. Because many women with PCOS have an increased level of luteinizing hormone, commonly prescribed therapy only FSH.
Stimulation of ovulation
If PCOS is one of the symptoms of anovulatory primary infertility
. In order to stimulate ovulation uses several methods of therapeutic effect
. First-line therapy can be called clomiphene
. It is prescribed strictly ascending pattern, beginning with a dose of 50 mg
. Subsequently, the dose is increased, thus evaluate treatment efficacy based on the results ultrasonograph
. In the course of the US should determine the size of the follicle, the presence of the dominant follicle and the endometrium
. Clomiphene may be administered in the first phase of the cycle of the fifth to the ninth day, or the third to seventh day
. Most effective therapy is observed in the availability of stored body's estrogen saturation, when the level of estrogen is not changed (for the study of estradiol)
. In the case where the level of estrogens in women is inadequate when conducted ovulation stimulation with clomiphene does not give adequate folliculogenesis process, it is necessary to select a method using gonadotropin stimulation
The drugs of choice are menotropiny or urofollitropin at a dose of 150 to 225 IU per day
. Stimulation of ovulation is carried out in a first phase with the third or fifth day for seven days
. You can continue treatment up to fifteen days
. The duration of treatment, its effectiveness, adequate dose can be based on an assessment of the dynamics of growth of the follicle
. Therapy is considered effective if the follicle growth per day is at least 2 mm by ultrasound
. If the follicle growth is slow, it is necessary to increase the dose of 75 IU
. In the case of the opposite situation, when there is an excessive rate of growth of the follicle, it is necessary to reduce the dose of 75 IU
. The appointment of the drug can be stopped when the follicle reaches a size of 18-20 mm, and the thickness of the endometrium will not be less than 8 mm
. This situation is a confirmation of ovulation, so welcome menotropinov stop, once added to the therapy of HCG (human chorionic gonadotropin) at a dose of 10,000 U
. It is sure to be carried out support the second phase of the cycle, after ovulation fact confirmed
. Hormonal support held the appointment of progestogens such as dydrogesterone at a daily dose to 30 mg
. Selection of an individual dose, so in some cases the dose may exceed the average therapeutic or be lower
Lack of effect of ongoing methods of ovarian stimulation is an indication for surgery (resection of the ovaries and other interventions), which is considered an important adjunct to conservative therapy.